NPI | 1013460625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: AK 112026) |
Enumeration Date | 2016-07-31 |
Last Update Date | 2023-12-12 |